ROTOKAURI SCHOOL INFORMATION BOOKLET 2020
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ROTOKAURI SCHOOL
INFORMATION BOOKLET
2020
Tena koutou katoa,
He mihi nui tenei ki a koutou katoa
Nau mai haere mai ki te kura o Rotokauri
Greetings to you all
A big welcome to everyone
Welcome to Rotokauri School
Rotokauri School offers your child a positive, nurturing, family learning environment.
Our students are well supported by their peers, staff and parents in a welcoming
community.
This booklet welcomes you as parents / caregivers of a child who attends Rotokauri
School and summarises information parents and students are most likely to find
useful.
SCHOOL INFORMATION
Address: 462 Rotokauri Road
RD9
Hamilton 3289
Phone: (07) 849 5068
Email: office@rotokauri.school.nz
Website: www.rotokauri.school.nz
Facebook: www.facebook.com/RotokauriSchool
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TABLE OF CONTENTS
2020 Terms and Holidays...…….……….……………..……………………..……….….………………..………. 9
Advertising in the newsletter ……………….………………………………………………………..……………… 9
Assemblies …………….…………….…………………………………………………...……………...……….. ... 9
Attributes……………………………………………………………………………………………………………… 6
Attendance Procedures………………………………….…………………………………………………………. 9
Before & After School Care ………………………….………………………...……………..……………….……10
Board of Trustees ………………………………………………………..………………………………..……….. . 8
Car park ……………………………………………………………………..…………………………...….…10 & 17
Cellphone Policy …………….…………………………………………………………………………………….. 10
Children’s Duties …………………………………………...…………..……………………………………...….. 10
Communication with Parents………..……………………………………………………………………………...10
Community Involvement ………………….….....………………………..…………………. …………..……… 10
Contact Details……….………………. …………………...………………...………………………………...…… 11
Cycling to School …………………………………………………………………………………………………… 11
Dental Treatment ……………………………...………………………………………………………...………… 11
Evacuation Drills……... …………………...………………………………………………………….……………. 11
First Aid and Medication …………………...………………………………………………………..………….... 11
Fundraising ………………………………...………………………………………………………………………. 11
Homework ………………………………...…………………………………………………….………………….. 12
Interschool Sports …………………….…..………………………………………………………………….……. 12
Lockdown Procedure…………………………………………………………………………………………………12
Lost and Found …………………………………………………………………………………………..………… 12
Lunch Orders ……………………………...………………………………………………………...…………….. 12
Mission Statement……………………………….………………….………………………………………………….5
Newsletters ………………………………………………….………………………………………...……………. 12
Office …………………………….…...……………………………………………………………….…………….. 12
P.T.A. …………………………………….………………………...………………………………….………. 8 & 16
Principal’s Comment..………………………….……………………………………………………………..….….. 4
Principles of our Rotokauri Curriculum………………………………………………………………………………7
Publishing Permission / Internet Use…………….………………………………………………………………… 6
Reporting………….. ……………………………….………………………………..……………………………… 13
Scholastic Book Club …………………………………………………..…………………………………………. 13
School Activities Donation …………….………………………………………………………………………….. 13
School Camps ……………………………………………………………………………………………………… 13
School Hours ………………………….………………………………………………………………...………….. 9
School Information ………………….…………………………………………………...…………………………. 2
School Library ……………………………………………………………………………………………………… 14
School Shirts ………...……………………………………………………………………………………………… 14
School Structure and Progress …………….……………………………………………..……………………… 14
Special Programmes …………..………………………………………………………….…………………………14
Staff Members ………………….………………………………………………………………………..…………… 8
Stationery …………………….……………………………………………………….………………………………14
Sunhats ……………………….………………………………………………………………………………………14
Swimming / Physical Education……...……………………………………………………………………………. 15
Swimming Pool—After School and Weekend Use ……………………...…………………………………….. 15
Values ……………………………………………...…………………………………………………….…………. ...5
Vision ………………….………………………...……………………………………………………….………..……5
Where Parents Are Not Together …………………………………………….…...…….……………..….………15
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PRINCIPAL’S COMMENT 2020
Thank you for selecting our school for your child’s education. We want your child to
flourish socially, emotionally, physically and educationally.
Our school believes in providing a positive environment ensuring that children look
forward to attending school.
By having positive relationships between children - teacher - parent we have
children that are more engaged in their learning.
We operate an open door policy at this school. Parents are actively encouraged to
be a part of our school culture.
Our school logo says Together We Grow, Together We Learn and this is embedded
in our motto of being a TEAM
T ogether
E verybody
A chieves
M ore
Together we will make your child’s education as happy, balanced and successful as
possible.
Welcome to Rotokauri School.
Kind Regards
Desiree Smith
PRINCIPAL
4
The foundations of our curriculum are built on the following:
MISSION STATEMENT
Our positive environment will actively engage us all in learning.
VISION
Together We Grow Together We Learn
Unity (Kotahitanga) Innovative (Auahatanga)
Inclusive (Manaakitanga) Happy (Uruhau)
Guardianship (Kaitiakitanga) Responsible (Tuutika)
VALUES— REACH
R - Respect E - Empathy A - Active Learning C - Courage H - Honesty
Respect Empathy
Whakaute Ngākau Aroha
This means we show that we value ourselves, value This means we are able to step into the shoes of
others, our school and our environment. another person and try to understand their thoughts
and feelings.
We know that we value this when we:
Choose to behave appropriately in different We know that we value this when we:
situations. See through the eyes of another person.
Look after ourselves, each other, our school and Listen to others’ feelings and points of view.
the environment. Use our empathy to support others during
Include others and be accepting of their difficult times and this will guide our actions.
differences and opinions.
Treat others the way we would like to be
treated.
Active Learning Courage
Mātātoa Mārohirohi
This means that we don’t give up, even when we are This means that we are brave as we face new
challenged. experiences and difficult situations.
We know that we value this when we: We know that we value this when we:
Think about our learning. Are willing to try new experiences.
Learn from our mistakes. Face things that are difficult or scary.
Practise to reach our goals. Make the right choice, even if it is hard for us.
Take risks in our learning.
Honesty
Ngākaupono
This means speaking and acting truthfully.
We know that we value this when we:
Are responsible for our choices and actions.
Tell the truth even if it is hard for us.
Do the right thing, even when no one is watching.
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ATTRIBUTES
A Rotokauri Learner Collaborator
I am a collaborator
I am always when I listen to ideas and
CREATIVE share my thinking with others.
and
Remember… We are a T.E.A.M
CURIOUS Together Everyone Achieves More
Communicator Problem Solver
I am a communicator I am a problem solver
when I competently and when I identify a problem
effectively communicate or issue, and identify the
using appropriate media. best possible solutions.
Questioner Risk Taker
I am a questioner I am a risk taker
when I ask a range of when I am keen to give new
relevant questions to support things a go, displaying a
the desired outcome. positive attitude.
PUBLISHING PERMISSION / INTERNET USE
Rotokauri School may include examples of students work and images of individuals and
groups of students in activities at the school in its newsletters, website and Facebook page.
Rotokauri School publishes student material online for the following purposes:
To educate the students in accordance with the National Curriculum including the role
and use of technology in society.
To encourage the student to be a part of and participate in the school
community.
To promote the school and student achievement in the wider community.
If you do not want your child’s photo to be published in school printed or online publications,
we ask that you write a letter to the school outlining your specific permissions and drop it into
the school office as soon as possible.
Also, while your child is attending Rotokauri School, there will be times that they are
instructed and supervised using the internet to improve their learning experiences.
6PRINCIPLES OF OUR
ROTOKAURI CURRICULUM
These principles guide the direction
of the Rotokauri Curriculum.
Learning to Learn
Students will develop the skills to manage their own learning.
Students will reflect on their learning process.
High Expectations
Students will be encouraged to achieve personal excellence.
Students will celebrate their own and others’ successes.
Coherence
Students will experience a balanced curriculum incorporating all learning areas,
key competencies and values.
Students will be encouraged to make connections in their learning.
Students will experience a supported transition to their next learning challenge.
Community Engagement
Students will be positively supported by an actively involved learning community.
Inclusion
Students will have their needs catered for in an equitable way.
Cultural Diversity
Students will respect cultural differences and traditions.
Treaty of Waitangi
Students will have the opportunity to learn Te Reo Māori.
Students will be supported by the Māori community.
Future Focus
Students will explore future focused concepts such as sustainability, citizenship,
enterprise and globalisation.
Students will be involved in environmental sustainability practices.
7BOARD OF TRUSTEES
The Board meet monthly. Any person may attend these meetings. Meetings are
usually held on Wednesdays nearest the 20th of each month. Members are:
Paul Burt Chairperson
Craig Zillwood Treasurer
Brad Kells Property
Rebecca Jackson Personnel
Desiree Smith Principal
Andrea O’Rourke Staff Trustee
Fiona Webber Minute Secretary
STAFF MEMBERS
Desiree Smith Principal
Jaimee Carter Deputy Principal / SENCO
Emma Vile Room 1
Andrea O’Rourke Room 2 (Assistant Principal)
Jaimee Swindells Room 3
Claire Walker Room 4
Diana Donovan Room 5
Ariana Matenga Room 6
Scott Robertson Room 7
Jane Rickman Room 8
Sharon Verstraten Administration Officer
Raewyn O’Brien Teacher Aide
Sarah Dyer Teacher Aide / Library
Rhianna Moka Teacher Aide
Hans Verberne Caretaker
P.T.A.
Cilla Molloy Chairperson
Tracy Wilson Secretary
Nicole Barham Treasurer
Raewyn O’Brien Staff Representative
Diana Donovan Staff Representative
Jaimee Carter Staff Representative
82020 TERM AND HOLIDAYS
Term 1 Monday 3rd February - Thursday 9th April
Term 2 Wednesday 29th April - Friday 3rd July
Term 3 Tuesday 21st July - Friday 25th September
Term 4 Monday 12th October - Tuesday15th December
Public Holidays - 2020
27th April - ANZAC Day Holiday
1st June - Queen’s Birthday
26th October - Labour Day
Teacher Only Days - 2020
25th March - Term 1
28th April - Term 2
20th July - Term 3
SCHOOL HOURS
8.55 am - 11.00 am
11.00 am - 11.30 am (morning interval)
11.30 am - 12.30 pm
12.30 pm - 1.20 pm (lunch)
1.20 pm - 3.00 pm
Children should leave home so as to arrive at school between 8.30 and 8.50 am. The
bell is at 8.55 am when all children are expected to move to classrooms. Learning
starts at 9.00 am. Please assist to keep lateness to a minimum.
If children arrive at school prior to 8.30 am they must wait in the bus bay. Children
should leave or be picked up by 3.30 pm.
There will not be any shortened day for wet weather. Supervised games and other
activities will be organised at wet lunch times.
ADVERTISING IN THE NEWSLETTER
A business card size advertisement can be placed in our newsletter for $60.00. We
publish 20 newsletters a year. These are distributed not only to our community but
nine early learning centres. Some people may want to trial the success of advertising
in our newsletter by paying $15.00 for five inserts (1 term) or $5.00 for one newsletter.
ASSEMBLIES
A full school assembly is held each week (2.25 pm on Fridays). This is a celebration
time where classes, teams and individuals are commended for their achievements.
Assemblies are held outside Room 4 or in the MPR. Parents are welcome to attend
assemblies. General notices are communicated at a short assembly on Mondays at
9.00 am.
ATTENDANCE PROCEDURES
From time to time, students need to have time off school If your child is absent, please
use the school app to notify the office. Alternatively email or call the office on
8495 068 and state your child’s name, class and reason for your child’s absence.
Parents will be phoned for any unexplained absences.
Child absences at Rotokauri School are tracked electronically by the classroom teacher
at 9.00 am and 1.30 pm. Poor attendance at school hinders the social and academic
progress of students. Continued unjustified absence will result in an interview with the
Principal.
It is important for your child’s health and safety that we know where your child is at all
times. Thank you for your co-operation.
9BEFORE AND AFTER SCHOOL CARE
Before and after school care is available at Rotokauri School. For further information phone
Atmosphere 0800 CREATORS or email atmosphere@creators.org.nz
CAR PARK
We have tried to make our car park system as simple as possible. There is a drop off zone to
the left of the top car park. Please follow the procedures below when using our car park.
1. If you are going to leave your car to collect your child from the classroom please do not
park in the drop off zone. If your child is not already waiting at the drop off zone, please
park in a car park and wait for them so you do not hold up traffic moving forward in this
area.
2. Please continually move to the front of the drop off zone when the opportunity arises
because of a departing car.
3. Please don’t encourage your children to run across the car park to your car. They
should use a pedestrian crossing.
4. Please do not drop off or pick up children at the pedestrian crossing as this can cause a
build up of cars behind you on Rotokauri Road.
Please view the map of the carpark on the back page of this booklet.
CELLPHONE POLICY
Students are not allowed cellphones at school. At certain times students may need to bring a
cellphone to school. If this is necessary it must be handed into the office for the day and be
accompanied with a signed note from a parent / caregiver. Students / parents can
communicate through the phone in the office or staffroom. Children must ask a teacher’s
permission before using our phones.
CHILDREN’S DUTIES
Students in the senior classes are required to assist with a duty at the end of a school day. As
long as the child works diligently, the task should take no longer than 5—10 minutes.
Not only does the duty system encourage children to take greater care of the school and foster
pride, but it provides a worthwhile source of income. This is because the Board of Trustees
pays a lump sum to the senior school camp fund each year in recognition of the work done by
the students.
COMMUNICATION WITH PARENTS
Regular contact is made between the school and families through different methods.
Our school newsletter is published once a fortnight, on a Thursday. This usually is emailed to
families but a hard copy can be requested.
Our school website features general information about the school, school event calendar and
class webpages.
The School Stream app can be downloaded onto your smartphone to receive instant
notifications of events, reminders and cancellations. This app is available on iPhone, Android
and Internet Explorer pages.
The school Facebook page is a great way to see photos from events and read good news
stories.
Seesaw: The Learning Journey app is used by students and teachers to share their learning
with families. This app is available on iPhone, Android and Internet Explorer pages. Teachers
can provide the log in details for your child.
COMMUNITY INVOLVEMENT
Education is a community endeavor and we invite parents and the community to be
involved in school activities. In an effort to enhance Parent—Teacher communication and
facilitate our school’s programmes, volunteers are welcome to help in the classroom, on school
trips and at school events.
10CONTACT DETAILS
If you change your address, phone number, emergency contacts or there is a
change in your child’s medical condition it is important to advise the office
immediately.
CYCLING TO SCHOOL
It is recommended that children should be ten years of age before biking to school
and it is law that they wear Standard Safety Approved helmets. If your child is
younger than 10, and you are allowing them to ride their bike to school, can you
please inform us in writing. Please provide a lock for your child’s bike.
DENTAL TREATMENT
The dental therapist will be regularly on site at school to screen and treat children.
It is the responsibility of parents with preschoolers to enrol your children and make
an appointment whilst the dental therapist is here. For any urgent dental treatment
required outside this time you may contact the Crawshaw School Dental Clinic
ph: 8497 308.
EVACUATION DRILLS
These are held once a term. All students and visitors meet on the bottom field when
the fire alarm, a continuous bell, is sounded.
FIRST AID AND MEDICATION
First aid material is kept in the sick bay. In the case of serious accidents, two
teachers decide on the action to be taken. Parents are contacted as quickly as
possible. From time to time children require medication. All requests will be on the
Parent Request for School to Administer Medication Form. Prior approval must be
sought / given before any medication is given. Ask for our Medication Policy for
further details and a request form. Mrs Verstraten is in charge of the medication.
FUNDRAISING
Throughout the year the P.T.A. organises a number of fundraising events. Here is a
sample of their past fundraising events:
Disco, Sausage Sizzle, Car Show, Easter Raffle, Oxford Pies, Chocolate selling,
Grant Applications, Tables of Eight, Christmas Calendars, Garden Ramble, Garage
Sale and Family Photos.
The P.T.A also support our camps financially and subsidise shows for the students.
The P.T.A. at Rotokauri School is a very proactive team of dedicated parents. If you
would like to help the P.T.A. out in any way fill out the form on the second to last
page.
11HOMEWORK
We encourage homework to provide a home - school learning partnership and to
establish life long study skills. However, teachers will respect that homework is a
parental choice. Homework handed in on time will be marked.
INTERSCHOOL SPORTS
These will take place throughout the school year. Where possible Year 4 and above
students will be encouraged to participate in a variety of sports. As well as using
buses, we rely on parents to provide transport. Our cluster group of schools include
Whatawhata, Te Kowhai, Horotiu, Te Uku, Te Mata, Raglan and Waitetuna.
LOCKDOWN PROCEDURE
A lockdown procedure will be rehearsed at least once a year. This is signaled by 10
short bells. Children are required to go to their own room for lockdown procedure.
Visitors make your way to the closest inside area.
LOST AND FOUND
Lost articles can be found in the blue bin in the Multi Purpose Room. These items will
be on display every Friday. Children and parents should check regularly. At the end
of each term, unclaimed articles are given to charity.
LUNCH ORDERS
The P.T.A. run a lunch order system that operates on Mondays. Children are required
to bring their money and order to the school office student foyer before 9.00 am.
Lunches are distributed to the children at 1.00 pm in the MPR. Items for sale and
prices are:
Lunch Menu is:
Potato Top Pie $3.50
Mince Pie $3.50
Mince & Cheese Pie $3.50
Lamb & Mint Pie $3.50
Small Mince Pie $2.00
Sausage Roll $2.00
Subway $6.00 Bread roll, biscuit and drink (Turkey, ham or beef)
Sushi $4.00 4 pack (salmon or chicken)
Sushi $7.00 8 pack (chicken, avocado, red capsicum and cucumber)
Wednesdays—online orders through www.lunchorders.co.nz and delivered to school.
NEWSLETTERS
Newsletters are emailed to families every second Thursday. Our newsletters are
informal and hopefully informative. As a part of Students’ Voice, our students will be
writing reports, poems and producing artwork for newsletters.
OFFICE
The office is attended each day between 8.15 am and 3.45 pm Monday—Thursday and
2.45 pm on Friday. If you require to speak to a teacher, please phone either before or
after school or at lunch time. The school phone number is 8495068. The most recent
newsletter is displayed on the notice board by the office.
12REPORTING
At Rotokauri School our door is always open, especially when it is to discuss your child’s
learning and progress. It is essential that we all have a clear understanding of your child’s
learning needs and progressions, and that we work together to support your child’s
learning.
We use a range of means to communicate individual student’s progress throughout the
year.
Written Reports
You will receive two written reports a year.
An interim report in Term 2 shows your child’s progress against the curriculum levels and
towards their learning goals, as well as identifying next learning steps.
An end of year report is the culmination of a year of learning and sums up your child’s
overall achievement and celebrates what has been learned.
When reporting, it is our aim to clearly show your child’s progress and achievement in
Reading, Writing and Maths, and to let you know of your child’s participation and
achievement in other areas of the curriculum such as Technology, Science, Social
Science, Health, Physical Education and The Arts.
Student Led Conferences
Student Led Conferences are held in Term 3 and give your child the opportunity to have a
conversation about their learning.
SCHOLASTIC BOOK CLUB
Twice a term children are given book club forms from which families can select books.
Orders are organised by Sarah Dyer. Online orders, directly to Scholastic are preferred,
otherwise send orders and cash to the school office.
SCHOOL ACTIVITIES DONATIONS
School donations are set at $100 per child ($25 per term), with a maximum of $250 per
family of 3 or more children. This donation provides an essential addition to the school’s
income and provides equipment, important classroom resources, library books, supports
sports teams and aspects of our cultural programme. It does not cover visiting artists,
trips to events outside school etc. Technicraft fees for Years 7 & 8 are separate at
$100.00 per child. If you wish to direct credit funds, the school’s bank details are ASB,
Account number 123152 0116129 00. Please make sure you have your child’s details
and what the payment is for recorded with your deposit. Please also let the school office
know that a payment has been made.
SCHOOL CAMPS
School camps are a very important aspect of our total curriculum programme. Children
find the camps most enjoyable and it is hoped that every child will have the opportunity to
participate in these valuable outdoor educational experiences. We keep the costs for the
camp at the bare minimum. Camp fees can be paid off during the year. You need to
make arrangements for this at the school office.
School camps are in class groups therefore it’s up to individual teachers where and when
camps are held.
13SCHOOL LIBRARY
The Library has a wide selection of both fiction and non-fiction books which are available
for borrowing by all children in the school. Each class is timetabled for library once a
fortnight. Books are issued and children are responsible for returning them by due dates.
There is also a computer housed in the Library for children to use for searching for
reference materials etc. A letter may be sent home requesting payment for missing
books. The money is used to replace missing books. Please see that your child develops
responsibility for looking after and returning borrowed books.
SCHOOL SHIRTS
The P.T.A. sell school shirts. These shirts are used for some of the school sports teams,
on class trips and for interschool events. They can be purchased from the school office
for $27.50.
SCHOOL STRUCTURE & PROGRESS
Distribution of pupils throughout the school, at present, enables us to have the following
class groupings.
Room 1 Year 1
Room 2 Years 1 / 2
Room 3 Years 3
Room 4 Years 3 / 4
Room 5 Years 5
Room 6 Years 5 / 6
Room 7 Years 6 / 7
Room 8 Years 7 / 8
SPECIAL PROGRAMMES
Our goal is to recognize those children with special needs / abilities as early as possible.
Teacher Aide and SENCO time is programmed to assist children with special needs.
Children with oral language needs are withdrawn for language enrichment.
New Entrant tests are taken by the SENCO.
Six Year Net testing is done by Jaimee Carter (SENCO) and then analysed to
identify students who need further help in reading or writing.
RTLB’s (Resource Teacher Learning and Behaviour) and RT Lits (Resource
Teacher of Literacy) may work with teachers to develop programmes to support
your child’s learning.
STATIONERY
We hold stocks of most stationery items required by pupils. Stationery can be purchased
from the school office from 8.30 am to 9.00 am each day. Stationery requirements for the
next year are sent home at the end of the year to be purchased in readiness for the
following year. There is an online system through OfficeMax for ordering the start of year
stationery.
SUNHATS
Wearing of Rotokauri hats is mandatory. Children wanting to play in an outside
environment in Terms 1 & 4 need to wear their hat. Children who do not wear a hat must
stay under the sunshade. Hats are available for purchase from the office at $18.00 each.
14SWIMMING / PHYSICAL EDUCATION
Unless your child has a doctor’s note or a note from yourself, he or she is expected to
participate in Physical Education. Often if they’re too ill for Physical Education, they should
not be at school. Swimming is part of our summer P.E. programme and only very good
reasons, such as skin disease or genuine physical ailments, are accepted for exemption.
SWIMMING POOL - AFTER SCHOOL AND WEEKEND USE
The pool is available to parents and families of Rotokauri School, subject to the following
conditions.
1. Entry is via the locked gate only. A limited number of keys are available for hire for
the season. These are obtained from the school office for $110 with a $10 refund
when the key is returned.
2. Key holders agree to any conditions which may be set from time to time. No copies
are to be made of keys. Key holders agree to take responsibility for the pool and its
patrons while they are in the school grounds.
3. At all times an adult (18 yrs) must be in charge of children from Yr 8 and below using
the pool, and must ensure that safety and hygiene rules are observed.
4. The pool must be locked after use.
5. The grounds must be vacated at sunset.
6. No running is allowed in the pool enclosure. Jumping and flips are not permitted. The
pool is too shallow for safe diving by children in the shallow end.
7. Before leaving the pool, you are responsible for the tidiness of sheds and pool
surrounds, making sure no property or rubbish is left behind.
8. The successful after-hours use of the pool depends on the co-operation of all users.
The Board of Trustees reserves the right to close the pool at any time, or to recall any
keys at any time. ALL keys are to be returned to the school when requested.
9. Key holders are not to lend their keys to other families. The pool is for our school
families and community only.
UNAUTHORISED USE OF THE POOL
1. Ask the name of the key holder. If entry has not been made by key, ask patrons to
leave. Unauthorised swimmers are trespassing and if necessary can be evicted by
the police if they refuse to leave.
2. Please report vandalism or hooliganism to Chairperson.
3. No polystyrene float boards are to be used in the pool.
WHERE PARENTS ARE NOT TOGETHER
Please help us by telling us if there are any special arrangements for your child. Unless a
court has ruled otherwise, both parents are entitled to copies of children’s reports, and have
the right to come to school to discuss the educational progress of their child / children and
to attend school functions.
15Rotokauri School PTA
Please return this form to the school office - thank you very much.
I would like to be involved in the P.T.A. Please let me know when the next meeting
is on.
I am unable to join the P.T.A but I would like to help out from time to time.
I am also able to assist in the following ways:
Fundraising assistance
Free to assist during school hours
Computer work at home
School lunches
Any other suggestions? E.g. contacts with helpful businesses…………………………..
………………………………………………………………………………………………………..
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
Name: ……………..…………………………………………………………………………….
Address: ……………………………………………………………………………………………..
…………………………………………………………………………………………….
Phone: …………………….…….Home ……………………………………...……Cellphone
Email:………………………………………………………………………………………………….
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